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News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
January, 2010, Vol. 10, Issue 01
Heating Up Your Practice Safely, Part 2
By Dixie Wall, Contributing Editor
In December's issue1 we discussed heat therapies and their positive effects in the treatment room. We covered treatment procedures such as skin typing, which will help us give an effective heat therapy treatment while minimizing the risks of burns. We mentioned the use of an informed consent document during the preliminary consultation and reviewed the most common mistakes that can lead to accidental burns. This month, we will discuss the gathering and assessment of subjective and objective information to formulate the best treatment plan for our clients.
First we will begin by reviewing the physiological effects of heat on the body. These involve the endocrine, circulatory and nervous systems. The body's temperature is regulated by the hypothalamus (endocrine system), which strives to keep the body in balance. Common therapeutic responses of the circulatory system include increased circulation and blood flow to the muscles by the vasodilatation of the peripheral nervous system. Sometimes the client will feel slightly sedated from heat by the release of neurotransmitters that tend to make us feel good and cause a decrease in pain and joint stiffness.
Nevertheless, there are certain conditions, diseases and body types that may cause abnormal reactions to heat therapy and/or compromise a client's perception of heat. There are several types of heat therapies used by massage therapists, the most popular include: hot stones, immersion baths, electric heating pads, moist heat packs (hydrocollater packs) and infra-red saunas. In order to use these tools safely, we must remain flexible to our client's individual needs by incorporating our intuition and professional knowledge. It may be best to check first with a client's primary care physician when working with sick patients. A certain client's condition or symptoms may be exacerbated by heat therapies. Considering the aforementioned therapies, what are the subjective and objective factors to consider when treating with heat therapies?
The first precautionary measure we can take is by simply asking our clients for a basic medical history. These findings are subjective unless we actually talk to, or receive a note from, a client's primary care physician confirming diagnosis given by the client. Most therapists gather subjective information by an initial interview where the client fills out a complete medical history on their first visit. This document should include, but is not limited to: medical background including medications and supplements, and an informed consent. Some therapists include an extra form specifically for hot stones, or other types of modalities to be filled out by the clients before treatment. Here are some of most common contraindicated and cautioned diseases and conditions to be aware of with use of heat therapies:
Contraindicated diseases and conditions:
Acute conditions and special needs clients:
Subjective information is essential, however, objective observations are equally important and effective when creating a treatment plan for clients. By careful observation, we can use our intuition to determine the particular need of each client. For example, noticing that a client is generally in a hurry, feels "hot," tends to sweat easily or is easily irritated may raise a red flag for heat therapies. This client's symptoms point to a general heat pattern in the body and may be exacerbated by adding more heat.
Many types of alternative medical practitioners use subjective and objective information in order to reach a diagnosis and treatment plan for their patients. Legally we cannot diagnosis, but a therapist can still gather information to formulate the best treatment plan for each individual client.
In traditional Chinese medical theory, a practitioner may avoid heat therapies such as moxabustion and fire cupping on certain types of patterns of disharmony or disease. A diagnosis or pattern of disease may indicate whether or not the patient has a too much or not enough heat. Generally, Eastern doctors will not use heat therapies on heat patterns (excess yang or deficient yin/ hot body types) but will use them on patients who have cold patterns (excess yin or deficiency of yang/cold body types) in their diagnosis to warm up the body. The practitioner's intention is to promote the balance of hot (yang) and cold (yin) within the body.
From a similar perspective, Ayuervedic medicine also tries to achieve balance through body typing and diagnosis, and tends not to use heat therapies on people with a high pitta conditions (since pitta represents the fire-water element in the Ayurvedic tradition).
If still not sure on whether or not to use heat, a therapist can palpitate the client's pulse. From a traditional Chinese medicine perspective, pulses over 80 beats per minute (BPM) indicate a mild heat condition and a pulse over 90 BPM indicates a severe heat condition. However, pulse rates can be affected by many factors that should always be considered.
Ultimately, we must always make the client's well-being our top priority by creating balance through the use of our modalities. We must remain flexible based on our clients' needs. Coupling both our intuition and education, we can provide safe and effective treatments for our clients. As always, I welcome and appreciate any comments or concerns at .
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